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Table 1 Main characteristics of modelling studies with GLA vs.NPH (listed in order of increasing ICER in €/QALYa)

From: Health economic evaluations comparing insulin glargine with NPH insulin in patients with type 1 diabetes: a systematic review

Author/study (year)
country/perspective/time horizon (discount rate) initiator
Type of economic evaluation/methodological approach Effect of GLA on HbA1c compared to NPH Effect of GLA on frequency of hypoglycaemia compared to NPH Long-term complications of diabetes Utilities Results for GLA compared to NPH ICERs in €/QALYa
Brändle et al. [25]        
Switzerland
third party payer perspective
40 years
(C 3.5%, E 3.5%)
Sanofi-Aventis
CUA
DES based on McEwan et al. [23] and DCCT
-0.19% points according to Mc Ewan [23] Symptomatic: -23%
Severe: -24%
Nocturnal: -24%
All reductions based on [7]
Reduction depending on HbA1c reduction Reduction by:
1. hypoglycaemia
2. fear of hypoglycaemia
3. long-term consequences
IU: 0.238 QALYs more
IC: CHF 1,476 less
ICER: GLA dominant
dominant
McEwan et al. [23]
Scenario 5
       
UK
NHS
40 years
(C 3.5%, E 3.5%)
Sanofi-Aventis
CUA
DES based on DCCT
-0.45% pointsb - Reduction depending on HbA1c reduction Reduction by:
1. long-term consequences
IU: 0.12 to 0.34 QALYs more
IC: £ 1,043 to £ 1,371 more
ICER: £ 1,096/QALY
€ 3,859
Warren et al. [24]        
UK
NHS
9 years (
C 3.5%, E 3.5%)
NICE
CUA
ScHARR Model
Only in sensitivity analysis:
-0.14% points [33]
Symptomatic: -42% [35]
Severe: -52% [35]
In sensitivity analysis reduction depending on HbA1c reduction Reduction by:
1. hypoglycaemia
2. fear of hypoglycaemia
3. long-term consequences only in sensitivity analysis
IU: n/a
IC: £ 573 to £ 816 more
ICER: £ 3,496 to £ 4,978 per QALY
€ 4,073 to € 5,800
McEwan et al. [23]
Scenario 1-3
       
UK
NHS
40 years
(C 3.5%, E 3.5%)
Sanofi-Aventis
CUA
DES based on DCCT
- Severe: -25 to -28%b
Nocturnal: -17 to
-22%b
- Reduction by:
1. hypoglycaemia
2. fear of hypoglycaemia
IU: 0.12 to 0.34 QALYs
IC: £ 1,043 to £ 1,371 more
ICER: £ 8,807 to £ 7,391 per QALY
€ 8,943 to € 10,656
McEwan et al. [23]
Scenario 4
       
UK
NHS
40 years
(C 3.5%, E 3.5%)
Sanofi-Aventis
CUA
DES based on DCCT
-0.19% pointsb - Reduction depending on HbA1c reduction Reduction by:
1. long-term consequences
IU: 0.12 to 0.34 QALYs more
IC: about £ 1,043 to £ 1,371 more
ICER: £ 1,096/QALY
€ 11,818
Grima et al. [22]        
Canada
Canadian health ministry
36 years (C 5%, E 5%)
Sanofi-Aventis
CUA
State Transition Model based on UKPDS and DCCT
-0.4% points [34] - Reduction depending on HbA1c reduction Reduction by:
1. long-term consequences
IU: 0.08 QALYs more
IC: CAN$ 1,398 more
ICER: CAN$ 20,799/QALY
€ 13,364
Warren et al. [20]        
UK
NHS
9 years (C 3.5%, E 3.5%)
NICE
CUA
ScHARR Model
Only in sensitivity analysis:
-0.14% points [33]
Symptomatic: -19% [20]
Severe: -52% [35]
Reduction depending on HbA1c reduction Reduction by:
1. hypoglycaemia
2. fear of hypoglycaemia
3. long-term consequences only in sensitivity analysis
IU: n/a
IC: £ 962 more
ICER: £ 32,244/QALY
€ 37,567
Cameron et al. [21]        
Canada
Canadian health ministry
60 years
(C 5%, E 5%)
CADTH
CUA based on
CORE-Model
-0.11% points [5] Moderate: -18% [5]
Severe: -18% [5]
Reduction depending on HbA1c reduction Reduction by:
1. hypoglycaemia
2. fear of hypoglycaemia only in sensitivity analysis
3. long-term consequences
IU: 0.039 QALYs more
IC: CAN$ 3,423 more
ICER: CAN$ 87,932/QALY
€ 57,002
  1. Legends: C = costs, E = effects, UK = United Kingdom, CADTH = Canadian Agency, CUA = Cost-Utility-Analysis, QALY = quality adjusted life-year, CORE = Centre for Outcomes Research, DES = discrete event simulation, NICE = National Institute for Health and Clinical Excellence, NHS = National Health Service, IU = incremental utilities, IC = incremental costs, ICER = incremental cost-effectiveness ratio, n/a = not applicable, ScHARR = School of Health and Related Research (University of Sheffield).
  2. aCurrencies transformed into Euro values via purchasing power parities (PPP), bunpublished material